Have you ever been convicted of a felony?________________
Do you use drugs and/or alcohol or smoke on a regular basis?_______________
I certify that the information that I have provided in this application is true and correct. I understand that if any of this information is found to be false after employment is granted, employment may be dismissed. I also understand that East Greenville Animal Hospital may conduct pre-employment and/or employee drug and/or alcohol screening/testing.
_________________________________________Signature of Applicant _____________ Date
Business References: (Do not list relatives) Please indicate if you were employed under a different name.